Samuel Mahelona Memorial Hospital
4800 Kawaihau Road, Kapaa, HI 96746
Samuel Mahelona Memorial Hospital is a nursing home in Kapaa, Hawaii. This page lists the citations, fines and star ratings that CMS publishes for it. Each one has a date and a link to CMS.
CMS star ratings
- 5 of 5CMS overall star rating
- 4 of 5CMS health inspection star rating
- 5 of 5CMS staffing star rating
- 4 of 5CMS quality measures star rating
Facts from CMS
- Phone
- (808) 822-4961
- Last standard health inspection
- May 14, 2026 (5 months ago)
- Certified beds
- 66
- Residents per day, on average
- 46.9
- Ownership type
- Government - State
- Legal business name
- Samuel Mahelona Memorial Hospital
- Chain
- Not listed by CMS
- Takes part in
- Medicare and Medicaid
Fewer health citations than the Hawaii average (18 vs 34).
Inspections, fines and changes
This list shows every citation and fine in CMS's current data, which covers about the last three years. It also shows changes CMS made to this home's ratings and records.
CMS update of July 29, 2026
Star rating
The CMS health inspection star rating changed from 5 of 5 to 4 of 5.
Star rating
The CMS quality measures star rating changed from 5 of 5 to 4 of 5.
8 citations
Health inspection on May 14, 2026
CMS lists this as a standard inspection and a complaint inspection.
Severity G is the second-highest of CMS's four levels. It means a resident was harmed.
7 of 43 Hawaii homes (16%) got a citation at the actual harm level in 2026.
Citation F0689. Severity G: actual harm, isolated.
The rule CMS cited:
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
CMS lists it as corrected on June 26, 2026.
Citation F0656. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
CMS lists it as corrected on June 26, 2026.
Citation F0812. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
CMS lists it as corrected on June 15, 2026.
CMS has cited this home for F0812 3 times since 2023.
Citation F0552. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Ensure that residents are fully informed and understand their health status, care and treatments.
CMS lists it as corrected on June 26, 2026.
Citation F0628. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
CMS lists it as corrected on June 26, 2026.
Citation F0761. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
CMS lists it as corrected on June 26, 2026.
CMS has cited this home for F0761 2 times since 2024.
Citation F0883. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Develop and implement policies and procedures for flu and pneumonia vaccinations.
CMS lists it as corrected on June 26, 2026.
CMS has cited this home for F0883 2 times since 2023.
Citation F0887. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.
CMS lists it as corrected on June 26, 2026.
Fine
May 14, 2026 (5 months ago)
CMS fine of $17,155 on May 14, 2026.
4 citations
Health inspection on November 22, 2024
CMS lists this as a standard inspection.
Citation F0812. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
CMS lists it as corrected on December 20, 2024.
Citation F0584. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
CMS lists it as corrected on January 3, 2025.
CMS has cited this home for F0584 2 times since 2023.
Citation F0761. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
CMS lists it as corrected on December 27, 2024.
Citation F0842. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
CMS lists it as corrected on December 27, 2024.
CMS has cited this home for F0842 2 times since 2023.
CMS update of October 30, 2024
Star rating
The CMS staffing star rating changed from 1 of 5 to 5 of 5.
CMS update of April 25, 2024
Star rating
The CMS overall star rating changed from 4 of 5 to 5 of 5.
Star rating
The CMS health inspection star rating changed from 4 of 5 to 5 of 5.
CMS update of January 31, 2024
Star rating
The CMS overall star rating changed from 5 of 5 to 4 of 5.
Star rating
The CMS staffing star rating changed from 5 of 5 to 1 of 5.
Name
CMS lists a new legal business name for this home.
Staffing
Total nurse staffing reported to CMS went from 5.2 to 3.6 hours per resident per day.
6 citations
Health inspection on December 1, 2023
CMS lists this as a standard inspection and a complaint inspection.
Citation F0812. Severity F: potential for more than minimal harm, widespread.
The rule CMS cited:
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
CMS lists it as corrected on January 5, 2024.
Citation F0578. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
CMS lists it as corrected on January 5, 2024.
Citation F0584. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
CMS lists it as corrected on January 5, 2024.
Citation F0609. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
CMS lists it as corrected on January 5, 2024.
Citation F0842. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
CMS lists it as corrected on January 5, 2024.
Citation F0883. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Develop and implement policies and procedures for flu and pneumonia vaccinations.
CMS lists it as corrected on January 5, 2024.
1 citation
Fire safety inspection on December 1, 2023
CMS lists this as a standard inspection.
Citation K0914. Severity D: potential for more than minimal harm, isolated.
The rule CMS cited:
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
CMS lists it as corrected on January 14, 2024.
1 citation
Fire safety inspection on September 30, 2022
CMS lists this as a standard inspection.
Citation K0363. Severity E: potential for more than minimal harm, pattern.
The rule CMS cited:
Install corridor and hallway doors that block smoke.
CMS lists it as corrected on December 28, 2022.
Owners and managers
CMS lists these owners and managers for this home. Names are as CMS writes them.
- SAMUEL MAHELONA MEMORIAL HOSPITAL5% or greater direct ownership interest · 100% · since 03/17/2017
- SAMUEL MAHELONA MEMORIAL HOSPITALOperational/managerial control · not applicable · since 04/01/2015
- ASATO, CHRISTINEOperational/managerial control · not applicable · since 04/01/2018
- FRANKLIN, NICHOLASOperational/managerial control · not applicable · since 08/16/2022
- SEGAWA, LANCEOperational/managerial control · not applicable · since 04/01/2018
Questions
When was Samuel Mahelona Memorial Hospital last inspected?
CMS lists May 14, 2026 as the date of its most recent standard health inspection.
How many citations (violations) does Samuel Mahelona Memorial Hospital have?
CMS lists 18 health citations since December 1, 2023. CMS also calls these deficiencies.
Has Samuel Mahelona Memorial Hospital been fined?
CMS lists 1 fine in the past three years, $17,155 in total.
What is the CMS star rating of Samuel Mahelona Memorial Hospital?
Its CMS overall star rating is 5 of 5.
Is Samuel Mahelona Memorial Hospital a Special Focus Facility?
No. CMS does not list it as a Special Focus Facility or a candidate.